head and cervical spine imaging
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Head and cervical spine imagingTRANSCRIPT
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HEAD AND CERVICAL SPINE- Emergency Radiologic Approach -
Ranieri Falcão AguiarRadiology Fellow
Radiology DepartmentSir Charles Gairdner Hospital
12-06-2014
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Head ct - approach
1. Midline2. Symmetry3. Basal cisterns4. Ventricles
Fundamentals of Diagnostic Radiology, 3rd ed.
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Head ct - approach
1. Midline2. Symmetry
Fundamentals of Diagnostic Radiology, 3rd ed.
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Head ct - approach
1. Midline2. Symmetry3. Basal cisterns
Fundamentals of Diagnostic Radiology, 3rd ed.
![Page 5: Head and cervical spine imaging](https://reader038.vdocuments.us/reader038/viewer/2022110307/556c9977d8b42a44468b4606/html5/thumbnails/5.jpg)
Head ct - approach
1. Midline2. Symmetry3. Basal cisterns
Fundamentals of Diagnostic Radiology, 3rd ed.
![Page 6: Head and cervical spine imaging](https://reader038.vdocuments.us/reader038/viewer/2022110307/556c9977d8b42a44468b4606/html5/thumbnails/6.jpg)
Head ct - approach
1. Midline2. Symmetry3. Basal cisterns4. Ventricles
Fundamentals of Diagnostic Radiology, 3rd ed.
![Page 7: Head and cervical spine imaging](https://reader038.vdocuments.us/reader038/viewer/2022110307/556c9977d8b42a44468b4606/html5/thumbnails/7.jpg)
Head ct - approach
1. Midline2. Symmetry3. Basal cisterns4. Ventricles
Fundamentals of Diagnostic Radiology, 3rd ed.
![Page 8: Head and cervical spine imaging](https://reader038.vdocuments.us/reader038/viewer/2022110307/556c9977d8b42a44468b4606/html5/thumbnails/8.jpg)
Head ct - approach
1. Midline2. Symmetry3. Basal cisterns4. Ventricles
Fundamentals of Diagnostic Radiology, 3rd ed.
![Page 9: Head and cervical spine imaging](https://reader038.vdocuments.us/reader038/viewer/2022110307/556c9977d8b42a44468b4606/html5/thumbnails/9.jpg)
Head ct - approach
1. Midline2. Symmetry3. Basal cisterns4. Ventricles
Fundamentals of Diagnostic Radiology, 3rd ed.
![Page 10: Head and cervical spine imaging](https://reader038.vdocuments.us/reader038/viewer/2022110307/556c9977d8b42a44468b4606/html5/thumbnails/10.jpg)
Head ct - approach
1. Midline2. Symmetry3. Basal cisterns4. Ventricles
EMERGENCY CT CHECKLIST1.Is the middle of the brain in the middle of the head?2.Do the two sides of the brain look alike?3.Can you see the smile and the pentagon or Jewish star?4.Is the fourth ventricle in the midline and more or less symmetrical?5.Are the lateral ventricles huge, with effaced sulci?
Fundamentals of Diagnostic Radiology, 3rd ed.
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Fundamentals of Diagnostic Radiology, 3rd ed.
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What to look for?• Fractures• Calvarium• Skull base• Orbit• Facial bones
• Hemorrhage• Epidural hematoma• Subdural hematoma• Subarachnoid• Intraventricular• Intracerebral hematoma
• Cortical contusions• Diffuse axonal injury
Fundamentals of Diagnostic Radiology, 3rd ed.
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fractures
Fundamentals of Diagnostic Radiology, 3rd ed.
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fractures
Fundamentals of Diagnostic Radiology, 3rd ed.
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Epidural hematomas
Fundamentals of Diagnostic Radiology, 3rd ed.
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Subdural hematomas
Fundamentals of Diagnostic Radiology, 3rd ed.
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Subdural hematomas
Fundamentals of Diagnostic Radiology, 3rd ed.
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Subdural hematomas
Fundamentals of Diagnostic Radiology, 3rd ed.
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Subdural hematomas
Fundamentals of Diagnostic Radiology, 3rd ed.
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Subarachnoid hemorrhage
Fundamentals of Diagnostic Radiology, 3rd ed.
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Diffuse axonal injury
Fundamentals of Diagnostic Radiology, 3rd ed.
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Cortical contusions
Fundamentals of Diagnostic Radiology, 3rd ed.
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CERVICAL SPINE
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Cervical spine - RADIOGRAPHS
STANDARD VIEWS•Lateral
•Antero-posterior
•Open mouth
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CERVICAL SPINE - ANATOMY
• SPECIFIC ANATOMY• C1• C2• SUBAXIAL
SPECIFIC FRACTURES
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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X-ray adequacy
Fundamentals of Diagnostic Radiology, 3rd ed.
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alignment
Fundamentals of Diagnostic Radiology, 3rd ed.
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Diag. and Surgical Imaging Anatomy Brain, Head&Neck, Spine. 2006
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alignment
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distances
Fundamentals of Diagnostic Radiology, 3rd ed.
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distances
Fundamentals of Diagnostic Radiology, 3rd ed.
ABOVE C4 < 1/3rd OF VERTEBRAL BODY
BELOW C4 < 1 VERTEBRAL BODY
*NOT SENSITIVE
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distances
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ROTATED
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TEARDROP FRACTURE
A-Z of Emergency Radiology, 1st ed. 2004
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JEFFERSON’S FRACTURE
A-Z of Emergency Radiology, 1st ed. 2004
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HANGMAN’S FRACTURE
A-Z of Emergency Radiology, 1st ed. 2004
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LOCKED FACETS
A-Z of Emergency Radiology, 1st ed. 2004
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C-spine
TO SUM UP
1.3 STANDARD VIEWS2.XRAY QUALITY3.ALIGNMENT 3 LINES4.FOLLOW BONE CORTICES5.DISTANCES• ATLANTO-DENS INTERVAL• PRE VERTEBRAL SOFT TISSUE• C1 LATERAL MASSES (OPEN MOUTH VIEW)• SPINOUS PROCESS AND DISK SPACES
6.CT7.MRI LIGAMENTOUS OR MEDULLARY INJURIES
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THANK YOU!